Trenton, NJ 08625-0360
April 17, 2000
TRENTON -- After rising sharply in the late 1980s and early 1990s, New Jersey's overall prostate cancer incidence rate peaked in 1992 and has declined slightly since then.
However, African-American men are much more likely than white men to get prostate cancer and are more than twice as likely to die of the disease, Health and Senior Services Commissioner Christine Grant said today.
These are among the findings of the state's first report on prostate cancer, Prostate Cancer in New Jersey 1979 - 1996, which is based on New Jersey State Cancer Registry data. The report examines trends in prostate cancer incidence and mortality, including the differing rates for white and African-American men. Prostate cancer is the most common cancer in men, except for skin cancer, and is the second leading cause of cancer death after lung cancer.
"Over the past decade, more men have been taking advantage of screening methods that can identify this cancer early, when treatment outcomes are more favorable," said Commissioner Grant.
"But we must reach even more men with this important message. And we must focus especially on African-American men, whose prostate cancer rates are unacceptably high," she added.
The New Jersey Department of Health and Senior Services now offers prostate cancer outreach, education and screening in 18 counties. Mercer and Atlantic counties will be added next month, and the Salem County program will be operating by July 1.
The program serves uninsured men over age 50, and specifically targets African-American men over age 40. Men receive counseling about prostate cancer and the issues surrounding testing and treatment before they are tested. As part of this program, the department also is developing educational materials that will be distributed to barber shops, African-American churches, fraternities and other groups that can reach men at high risk.
According to the report released today, the state's overall prostate cancer incidence rate rose gradually from 75.9 cases for every 100,000 men in 1979 to 84.8 in 1987. In 1988, the rates began climbing from 91.1 to the peak of 194.2 in 1992. The rate has since declined to 155.0, according to preliminary 1997 data included in the report. Similarly, mortality rates have risen from 22.7 in 1979 to 29.0 in 1993, and have since declined to 25.2 in 1996.
New Jersey's trends in prostate cancer incidence and mortality mirror those seen nationally, and may be related to the more widespread use of screening methods such as the prostate specific antigen (PSA) test and the digital rectal examination. This could explain at least part of the rising incidence rates and drop after 1992, as men who might otherwise have been diagnosed later were diagnosed at an earlier stage of disease.
According to the report, prostate cancer incidence rates for black men were more than 50 percent higher than for white men during the period 1979 - 1996 (162.1 vs. 104.5). A similar racial gap was seen in preliminary 1997 data. African-American men also had a lower percentage of their cancers diagnosed at the early stages than did white men for the period 1984 - 1996, when the data on stage of diagnosis were most complete.
Black men's prostate cancer mortality rates were more than double the white rate both in 1996 (54.2 vs. 23.0) and during the period 1979 - 1996 (51.3 for black men and 23.5 for white men), the report notes.
The cause of prostate cancer is not known, but a family history of the disease places a man at higher risk. Other potential risk factors include high fat consumption in the diet, smoking and alcohol consumption. The higher death rates among African-Americans may be related to their higher incidence rates and the fact that their cancers are more likely to be diagnosed at a later stage.
Almost all men eventually develop microscopic cancerous changes in the cells of the prostate. But only 10 percent of them go on to develop symptomatic prostate cancer. Many prostate cancers are slow-growing and may not progress to life-threatening illness.
There is not yet a national consensus on screening guidelines for prostate cancer. The Department of Health and Senior Services recommends that all men over age 50 be screened annually, as should men over age 40 who are black or at high risk because of their family history. Screening should include the digital rectal exam and may include the PSA test, which is a blood test. Before testing, men should be informed of all issues related to testing and treatment.
The prostate cancer report is available on the department's web site at www.state.nj.us/health or by calling (609) 588-3500. To find a prostate cancer screening site in your county, call the New Jersey Department of Health and Senior Services, Cancer Education and Early Detection Program at (609) 292-8540.